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Heart Healthy Diet

January 2008

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Healthy Lifestyle

In this issue ......

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Watching your weight

Chest pain translates into a 999 call Dr. Sandy Gupta, British Heart Foundation Aspirins and Statins for the heart Dr. Mahendra Patel, University of Bradford Medical Tourism S Jagadeesan, Minister Economic, High Commission of India in London Private health insurance Tim Smithers, Senior PMI Adviser, Medisearch Direct Ltd. Holistic beauty care Shahnaz Husain Using NHS services in Luton Aesthetic plastic surgery BAAPS and other experts

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Comment

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ne of the great British institutions, the National Health Service, will turn 60 in July this year.

Despite the ups and downs and the frequent onslaught of bitter criticism it has come under, the nation owes much to the NHS. The lives of millions has depended on it for six decades and will continue to in the foreseeable future. One can argue endlessly on its merits and drawbacks depending on, perhaps, which side of the political divide you belong to but the NHS has stood the test of time admirably and I honestly believe that this is a moment to pause and cherish.

Recently in his first major speech on the NHS since coming to office, Prime Minister, Gordon Brown, announced plans for national screening programmes to detect the early signs of heart disease, strokes, kidney disease, and diabetes with the aim of creating a more 'personal and preventative system'. He also outlined proposals to implement more diagnostic tests in GP surgeries, including blood tests, electro-cardiograms and ultrasounds. Successful implementation of these measures is key to the Government's drive to meet the maximum 18 week waiting time target from diagnosis to treatment.

Long waiting times has been the bane of the NHS and one hopes that these measures will stem the rot.

Health issues have been a major concern for the Asian community. Several ills plague the community and some of these are clearly avoidable through lifestyle changes. Simple and proven measures such as healthy diet, regular exercise and frequent check ups can significantly reduce the spiralling malaise. As the saying goes - prevention is better than cure. We have included some practical tips and indeed expert advice for healthy living from several healthcare professionals in this edition.

In recent years there has been a growing interest in cosmetic surgery and non-surgical aesthetic procedures in the United Kingdom. Influenced by an ubiquitous celebrity culture, Bollywood beauties and other modern day allures, the young and the not-so-young members of the Asian community are fast making a bee line to go under the knife. This edition carries some sound advice on the dos and don’ts of this often contentious procedure. Expert opinion has it that the choice of an accred-

ited plastic surgeon and accredited medical staff, with an accredited facility with specialist nurses is vital to a successful cosmetic surgery. You can read more about it in this edition.

Asian Voice and Gujarat Samachar have always placed heavy emphasis on health issues and we are aware from readers’ feedback that healthcare is of paramount importance to them. On behalf of our readers I extend my sincere appreciation to all the experts who have contributed gratuitously to this magazine; let me assure you that you have served a worthy cause. I hope that this edition of HEALTHCARE makes for enjoyable reading and readers will be enriched by its contents.

Finally, a big thank you to my colleagues at the ABPL Group, Cecil Soans, Alka Shah, Harish Dahya and others for their inputs into this magazine.

CB Patel Editor / Publisher Asian Voice and Gujarat Samachar

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Heart Disease in South Asians

Dr Kiran Patel, Consultant Cardiologist and Honorary Senior Lecturer, Sandwell Hospital and University of Birmingham, Chairman of the South Asian Health Foundation and Sister Ranjit Dhillon, Cardiac Specialist Nurse, Sandwell Hospital, and Member of SAHF Cardiovascular Group

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south Asian is defined as an individual who is either from, or has roots in India, Pakistan or Bangladesh. It is widely acknowledged that south Asians, when compared to white Europeans, have a higher risk of coronary heart disease (CHD). There is no single reason for this, but a complex interplay of factors puts these populations at risk of developing more severe heart disease earlier in life.

Some alarming facts South Asian mortality (death rate) from CHD is 46% higher in men and 51% higher in women when compared to the UK white population.

South Asians have the highest overall and premature CHD mortality of any UK ethnic group. Mortality rates are double in the 30-40 age group and tripled in the 20-30 age group. An audit in one part of Birmingham, showed that the rate of heart attack under the age of 60 years was almost 4 times greater than expected in south Asian men and almost twice the number expected in south Asian women.

These CHD rates occur despite a falling trend in the incidence of CHD in the general population. Despite this, the south Asian CHD epidemic is prevalent and suggests that more must be done to bring south Asians rates of heart disease down.

The current risk of CHD is far greater than that predicted by the models used to determine whether an individual should receive preventative therapy. Indeed, it is widely accepted that, at least in south Asian men, the risk of heart disease is underestimated by approximately 50%.

Why are disease rates so high?

There is no single reason to explain why south Asians are more susceptible to heart disease. Let me dispel one common misperception; people often say that some families have bad genes, predisposing them to heart disease. There is no single specific gene identified which causes heart disease. Families tend to share the same risk factors for heart disease and this is why the disease often occurs in several family members.

Indeed, there are few south Asian families who do not have a family member afflicted by heart disease or stroke. So what are these risk factors which make us prone to developing heart disease?

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Risk factors for heart disease We can split risk factor into those which are modifiable i.e. which we can do something about, and those which are non-modifiable.

Our genetic make up is fixed and non modifiable.

Although I have said there is no specific gene which causes heart disease, our overall genetic make up predisposes us to developing diabetes Dr Kiran Patel and heart disease when we move from an environment where we eat less and have high levels of physical activity e.g. on farms in India, to an environment where we exchange this healthy lifestyle for one where we exercise less and eat more e.g. when we migrate to cities or lead an urbanised lifestyle. There is a simple equation in order to maintain a stable weight energy in (food) must equal energy out (activity) and when this becomes imbalanced we put on weight. The transition from a relatively less affluent to an affluent environment has been responsible for much of the epidemic of heart disease Sister Ranjit Dhillon and diabetes in the Asian population.

Age is another non modifiable risk factor. As we get older, we are at greater risk of most diseases, including heart disease. We cannot get younger (unfortunately !) but we can reduce the risks of old age by leading healthier lives in youth. This should begin very early on in life.

One of the most worrying factors is the diet of Asian children. After birth, rates of breast feeding are unfortunately low although this healthy form of nourishment should not be discouraged. Once children begin to eat, their diet should be balanced with plenty of fruit and vegetables.

Giving children high calorie foods and food rich in oil, butter, ghee or sugars, predisposes them to heart disease and diabetes. Post mortem studies have shown streaks of cholesterol in the arteries of children as young as two years and we are also now seeing diabetes in

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south Asian teenagers as a consequence of poor lifestyles in childhood. This depressing trend must stop and the changes must begin in childhood.

Modifiable risk factors *Exercise is good for you and the recommended levels are 30 minutes of activity, five times weekly. This does not necessarily mean going to the gym every day. One can climb stairs instead of taking lifts, or reduce car use i.e. small changes in lifestyle.

What about diet? In a previous article in Asian Voice, I talked about a heart healthy diet. This is the cornerstone of good health. Briefly, this is summarised as:

Go for a Mediterranean-style diet, with lots of vegetables and fruits along with fish and small amounts of lean meat, Include some wholegrain foods in your daily diet, for example, wholegrain cereals, granary bread, wholemeal atta, brown rice, Watch out for trans-fats in processed foods which can also raise your cholesterol levels e.g. hard margarine, pastry, cakes and biscuits, Cut down salt, If you drink keep your alcohol intake within sensible limits, Make the change to reduced-fat dairy products, e.g. semi-skimmed milk, low fat yoghurt and paneer from semi skimmed milk, Use pure cooking oil, mono or polyunsaturated, rapeseed or olive oil, sunflower or corn oil instead of ghee or butter, Help not harm: Take only fruit, not sweets to the temple.

Another modifiable risk factor is tobacco intake. It does not matter whether one smokes, snuffs or chews tobacco, it still increases the risk of heart disease (and cancer), so stop it.

There are other risk factors your doctor should be able to help you with and it is reasonable for you to ask your doctor to measure these and for you to ask what your risk of heart disease is.

Blood pressure should be controlled and can be

reduced by adhering to a low salt diet Cholesterol.

There is both good and bad cholesterol. Many people take tablets called statins if diet alone is insufficient to lower their bad cholesterol levels. Excessive cholesterol basically builds up in the arteries and if it accumulates in arteries supplying blood to the heart, these arteries can block, leading to a heart attack (muscle death due to inadequate blood supply) Diabetes is very common in south Asians. Up to 25% of us are diabetic and the risk increases if a family member is also diabetic. If you have symptoms of thirst, need to urinate either at night or very frequently, or if you think you are at risk, your doctor can easily test for diabetes.

Treatments If you are at risk of heart disease, a change in lifestyle as discussed above is necessary and some people may require medication too. Therefore, if you do have a family member with heart disease or stroke, it is reasonable to ask your doctor to assess your risk of heart disease.

If you already have angina or have been treated for heart disease, you must ensure you have access to all available treatments, ranging from medication to different forms of surgery. There is no shame in asking for help, being on treatment, or having surgery. In fact, it is those who are fear the stigma of suffering from heart disease who suffer the most from this treatable disease.

What is being done?

The NHS now accepts that prevention is better than cure, so screening high risk groups such as south Asians should become a practice. We now have a wealth of research and guidelines informing us how to manage heart disease. Treatment provision is widely available and simply needs to be accessed. Most Asian men over 40 years should be on statin tablets.

Community Health Programmes The South Asian Health Foundation is a UK charity which holds seminars and meetings in communities around the UK (the SACHE programme), discussing the information I have provided in greater detail. They are held by healthcare professionals who come to your communities and are free of charge. Should you wish your community to benefit from one or several of these meetings, please contact us at info@sahf.org.uk or call on 07771 933 939. For further information on south Asian health please look at www.sahf.org.uk.

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Medicines for the Heart

Dr. Mahendra G Patel – Lecturer, School of Pharmacy, University of Bradford discusses ASPIRIN and STATINS and why you take them.

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reat improvements have been made in treating heart disease, largely due to the research and development of new medicines or drugs. These new drugs are effective because they are powerful. If you have been prescribed one, you need to know what you are taking, why you have been given it, how to take it, and what effects it will have.

Why are there so many different drugs?

Many different drugs are used to treat heart disease, but they all belong to a few main categories. The drugs within each category are similar, but they may have minor variations which are important for some people. As a result, doctors have a wide variety of drugs to choose from and can choose those that best meet the needs of an individual patient.

A single drug may have several names. The reason for this is that each drug has one official name (called the 'generic name' or the ‘non-proprietary name’) but it may also be prescribed under one or more trade names (called 'proprietary names'). A combination of two or more drugs is usually designated a single trade name. Whenever generic drugs are prescribed, the pharmacy dispensing the medication may use various manufacturers and it may be that the drug concerned may differ in appearance to that which you are normally familiar with. It is important to check with the pharmacy (if you have not already been informed) that the medication received is the same as the one you have previously been prescribed.

What do heart drugs do?

Most drugs used to treat heart conditions change how the heart or the circulation works, rather like a mechanic tuning an engine which is not working as well as it should.

How are heart drugs taken?

Drugs can be taken in a number of different ways.

Orally - Most drugs for the heart are taken orally (by mouth) either as tablets or capsules which you swallow.

Sublingually - When you place a tablet under the tongue and allow it to dissolve.

Aerosol spray - When the drug is contained in an aerosol spray which you direct into the mouth, under the tongue.

Self-adhesive patch - You place a patch containing the drug on the skin and the drug is absorbed through the skin.

Intravenously - When a drug is injected directly into a vein ('bolus' injection), or in a diluted form through an intravenous drip.

Intramuscularly - When a drug is given by an injection into a muscle such as the buttock or thigh.

Subcutaneously - When a drug is given by an injection

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just under the skin.

(Subcutaneous means 'under the skin'.)

How often do you need to take the drugs?

Some drugs need to be taken only on an ‘as required basis’ when a symptom develops, for example in the case of angina. Others, such as those for treating high blood presDr. Mahendra G Patel sure or preventing angina and heart attacks, need to be taken regularly, as your doctor has prescribed. In most cases, you need to take the medication once or twice a day but sometimes more frequently. Certain drugs however are designed to deliver the active ingredients over a twelve or 24-hour period. These are referred to as sustained release or modified release preparations. In such instances it is vitally important to take the medication every twelve hours (twice daily) or 24 hours (once daily) i.e. at the same time of the day as directed by your doctor for maximum benefit.

For further information regarding medicines and possible side effects please consult your pharmacist.

Patient Information Leaflet A Patient Information Leaflet (PIL) is often enclosed with the medication that you receive. Whilst it lists the possible side effects your medication can cause, most are often not common. However should you have cause for concern then you must refer to your pharmacist or doctor for further advice.

Before you decide to take any Over-The-Counter (OTC) remedies for minor illnesses it is important to let the pharmacist know what medicines you are currently taking. Some OTC medicines can directly affect blood pressure and interact with medicines for the heart.

ASPIRIN Aspirin is an antiplatelet drug and its chemically name is acetylsalicylic acid.

What is aspirin used for and how does it work?

Aspirin has been used for relieving pain and fever for many years, but nowadays it is more commonly used among those who have cardiovascular disease including heart attacks and strokes, and angina. It helps to reduce the risk of death by preventing further attacks from occurring; almost by one sixth in some instances. It may also be prescribed for those who have undergone coronary bypass surgery as a result of reduced blood flow caused by narrowing of the coronary arteries. A clot may occur within the arteries supplying blood to the heart (coronary arteries) in people with coronary heart disease. This increases the risk of further heart attacks.

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Aspirin works by stopping blood from clotting, a process which involves small blood cells, known as platelets, clumping together in the presence of a protein called fibrin.

How do I take aspirin?

Your doctor would generally advise that aspirin is taken orally on a daily basis. In the treatment of cardiovascular disease it may be combined, where appropriate, with other medication such as diuretics (water tablets), Angiotensin Converting Enzyme (ACE) inhibitors and calcium channel blockers. It is not advisable to take aspirin on a regular basis without your doctor’s advice as it can cause side effects such as bleeding from stomach ulcers.

Does aspirin have side effects?

The main and common side effects involve mild stomach disorders including indigestion, nausea and vomiting.

However, on occasions these can develop to become more serious and cause bleeding in the stomach. Manufacturers now make sugar coated (enteric-coated) versions of aspirin to reduce such side effects and alternatives such as clopidrogel (plavix) may be prescribed where aspirin is considered by the doctor to be unsuitable. Other less common side effects of aspirin include breathing related difficulties as well as allergic reactions. These may be potentially harmful and for this reason aspirin is not used in the prevention of coronary heart disease among healthy people.

When is Aspirin not suitable?

Aspirin is not recommended for those with uncontrolled hypertension (high blood pressure) unless advised by the doctor, as well as those suffering from asthma and related breathing disorders. Those suffering from stomach ulcers, or allergies caused by anti-inflammatory drugs, and women who are known or are likely to be pregnant, must also seek medical advice before taking aspirin mm

Commonly known names of Aspirin Non-branded (generic) Aspirin (enteric coated) Caprin, Microprin, Aspirin dispersible or soluble

Equivalent brand (proprietary) Nu Seals Aspirin, Gencardia Angettes

Those who are already prescribed oral anticoagulant drugs (to prevent blood from clotting) should avoid aspirin unless advised by your doctor.

STATINS Statins belong to a group of drugs often called ‘cholesterollowering drugs’ or ‘lipid-lowering drugs’.

They help reduce high levels of cholesterol, the fatty substance circulating in the blood, and in particular the ‘bad’ cholesterol – Low Density Lipoprotein (LDL) cholesterol. This ‘bad’ cholesterol is believed to cause the build up of fat in the arteries that can lead to coronary heart disease. Statins can reduce total cholesterol levels by more than 20% and

and LDL cholesterol by 30% or more.

Reducing total cholesterol levels helps protect healthy, but high-risk, people from heart disease and prevents repeated problems in those who have already had a heart attack (myocardial infarction), as well as stroke or peripheral artery disease. Treatment with statins is effective in preventing the number of heart attacks and deaths from occurring. Their use is invariably combined with advice on healthy eating and lifestyle.

How do they work?

Cholesterol is naturally made by cells in the body and is largely manufactured in the liver. It is made from saturated fats in food and is important in maintaining cell membranes and making essential chemicals such as hormones.

Statins work by blocking the enzyme (chemical) in the body responsible for the production of cholesterol. The amount of cholesterol produced by cells all over our body is reduced and as a result the cells have to rely upon the removal of cholesterol from the bloodstream. The overall effect is a lowering in blood cholesterol level

What are they commonly prescribed as?

They are prescribed by a doctor under one of their common names mentioned below and are available as tablets and occasionally as capsules: Non-branded Simvastatin Atorvastatin Pravastatin Fluvastatin Rosuvastatin

Equivalent brand (proprietary) Zocor Lipitor Lipostat Lescol Crestor

Simvastatin is also available as a combination product with ezetimibe under the brand name of Inegy.

Low-dose statins are also now available at pharmacies and may be purchased without a doctor’s prescription. It is worth commenting that these are not substitutes for prescribed statins.

How often do you take statins?

They are taken orally on a regular and daily basis, usually in the evening for maximum effect unless otherwise advised by the doctor. Cholesterol is made mostly during the night.

What are the common side effects of statins?

Minor side effects caused by statins include headaches, stomach pain, diarrhoea and sickness. However, patients may occasionally experience more serious side effects such as unexplained cramps, tenderness or weakness of the muscles during treatment. They must refer to their doctor as soon as possible in these cases.

Who are statins not suitable for?

They are not normally recommended for patients with liver disease, during pregnancy or while breast-feeding.

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In any language chest pain translates into a 999 call Dr Sandy Gupta, Consultant Cardiologist, Whipps Cross and St Bartholomew’s Hospitals, London, Chairman, BHF Strategy Committee on CVD in Ethnic Minorities

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ecent research by the British Heart Foundation (BHF) has revealed South Asians suffering chest pain are risking their lives by delaying a call to 999 because they think nobody at the call centre will speak their language.

This is a worrying misconception, which the BHF is working hard to change as part of its nationwide ‘Doubt Kills’ heart attack awareness campaign.

The fact is that 999 call centres do have translation services and can swiftly deal with an emergency situation despite the caller not speaking English.

Language Line Services works closely with the ambulance services to ensure that all people who speak a language other than English can be helped speedily by the 999 operators.

Ian Knibbs, from Language Line Services, explains: “When a non-English speaker calls 999, the ambulance service connects them to Language Line, who identify within a few seconds what language the person is

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speaking. They then pass the call to an interpreter who speaks the same language, while still keeping the ambulance operator on the line.

“This entire process always takes less than 60 seconds – and often as little as 30 seconds. Language Line is very familiar with South Asian languages, so we are able to deal with the call quickly and efficiently.”

Despite 88% of South Asians recognising the BHF’s high profile ‘Doubt Kills’ campaign which asks people to call 999 immediately when they experience heart attack symptoms, 46% still say they would wait longer than an hour before calling 999 if they had chest pain. Of this group most would wait 1-2 hours to see if the pain passed.

This is especially worrying as evidence shows that getting treatment within 1-2 hours of the onset of heart attack symptoms doubles your chances of survival.

The fact is that for every minute you deliberate about chest pain you waste further time in seeking lifesaving treatment. If you wait because you are unsure about your symptoms or because you are concerned about the language barrier, you are risking death or permanent damage to your heart – if the pain isn’t excru-

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ciating, it doesn’t mean it isn’t life-threatening.

The problem is most people in the UK are not good at recognising when they are having a heart attack – perhaps due to a widespread perception, fostered by Hollywood and Bollywood, that a heart attack is always a dramatic event, where, out of nowhere, someone collapses in agonising pain clutching their chest.

Whilst this can happen, the reality is a heart attack is often more subtle than that. The classic tell-tale sign is central chest pain, but it doesn’t have to be agonising to be potentially life-threatening. The most common mistake people make is to assume it is indigestion, so anyone experiencing bad indigestion-like symptoms should call for help, particularly if they are not prone to indigestion normally.

The ‘Doubt Kills’ campaign has had a positive impact in the South Asian community with a 17% increase in awareness of heart attacks while there has also been a 14% increase in awareness of chest pain.

We now need to build on these breakthroughs by getting the message out there that if you call 999 there will be someone who speaks your language who can help. There is no reason not to call. In anyone’s language, chest pain justifies an immediate call to 999.

As the BHF’s recent heart statistics show coronary heart disease remains the UK’s single biggest killer and heart attacks continue to both threaten and claim the lives of hundreds of people a day. And as the South Asian population in the UK have a 40-50% higher death rate from heart disease people need to be acutely aware that calling 999 is the only option when experiencing chest pain and heart attack symptoms.

Don’t wait to see if it gets better, don’t take a rest in the hope it will go away. And most of all, don’t call your GP to make an appointment. This could cost you your life and with 28% of South Asians saying they would prefer to call their doctor when they have chest pain this is a real concern. It wastes precious time.

We know calling 999 is proven to be the fastest way to get the best treatment for heart attacks.

Paramedics are able to commence immediate clot-busting treatment with special drugs which can save your life and your heart muscle.

The BHF campaign has the support of all ambulance services across the UK. Hayden Newton, Chief Executive of the Ambulance Service Association, says: “People need to know that we want them to call 999 if they are experiencing chest pain. It might or might not be a heart attack - but if you’re not sure, let us make that decision.

“All ambulance services in the UK are backing the BHF’s campaign because we’re all in the business of saving lives and we’d rather attend a false alarm than arrive too late.”

Someone suffers a heart attack every two minutes, and about one in three dies before reaching hospital. Many more suffer life-long debilitation because their heart muscle has been permanently damaged –

there are more than 900,000 people living with heart failure in this country.

The BHF is working hard to reverse these statistics through its ‘Doubt Kills’ campaign – all people need to do is recall its simple message – if you get central chest pain call 999 immediately.

People are urged to visit the campaign website, bhf.org.uk/doubtkills, for more information about how to recognise the symptoms of a heart attack and what to do.

The BHF also has a range of free publications in Urdu, Hindi, Bengali, Punjabi and Gujarati, including booklets and DVDs about heart failure, prevention of heart disease, cardiac surgery and rehabilitation. For a full list of publications or to order, call 0870 600 6566 or visit bhf.org.uk/publications.

HEART ATTACK SYMPTOMS The common or classic symptoms of a heart attack include: Central chest pain (a pain in the centre of the chest).

The pain can spread to the arms, neck or jaw.

Some people can feel sick or sweaty as well as having central chest pain.

Some people can feel short of breath as well as having central chest pain.

While women can experience the classic symptoms they often experience less common heart attack symptoms than men, such as: A dull pain, ache, or ‘heavy’ feeling in the chest.

A mild discomfort in the chest that makes you feel generally unwell.

The pain in the chest can spread to the back or stomach.

Some people say that the chest pain feels like a bad episode of indigestion.

Some people can feel a bit light-headed or dizzy as well as having chest pain.

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Using NHS Services in Luton

Cate Bickmore, Communications Manager Luton tPCT

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oday’s health service offers lots of choice – that’s as true in Luton as anywhere. By making the right choice at the right time, you’ll get the best possible treatment. If you, or a friend or family member, feel unwell, the following information can help you decide where the best place is to go.

Self care – can you treat yourself at home?

Keeping a well-stocked medicine cabinet at home can help you to treat many minor ailments that do not last long. Coughs, colds, indigestion and many other minor complaints can all be relieved by medicines that you can buy over the counter from a pharmacy. Your pharmacist can tell you what might be useful to keep in your medicine cabinet. Always follow the instructions on the medicine label, and consult your doctor if the illness persists or gets worse.

Your pharmacist – have you visited your pharmacist?

Pharmacists are qualified to offer (free) health advice at any time, no appointment needed. From coughs and colds to aches and pains, they can give you expert help with everyday illnesses. They can answer questions about prescribed and over-the-counter medicines, as well as give advice on healthy eating, obesity and giving up smoking. Some pharmacists have private areas where you can talk in confidence. They may suggest a visit to the GP for more serious symptoms.

NHS Direct – a 24-hour telephone service, staffed by experienced NHS nurses and other health professionals. You can use languages other than English.

If you feel unwell, you can ring NHS Direct at any time of the day or night and speak to a nurse. The nurse will advise you on what to do for the best. If you want information on particular health conditions, then NHS Direct can supply that too. They can also tell you where to find your nearest GP, pharmacist (including which pharmacy is open late), dentist or support group. Call NHS Direct any time on 0845 4647. To use a language other than English, give the name of the language that you want to use, in English, to the person who answers the phone. NHS Direct will then arrange for an interpreter to join the line.

NHS Direct online If you have internet access, there is lots of health advice and information on the NHS

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Direct website, www.nhsdirect.nhs.uk. There’s a selfhelp guide to treating common health problems at home, an encyclopaedia covering hundreds of illnesses and conditions, and a directory of local health services such as doctors, pharmacists and dentists. You can also find out more about local health services – and about health in general – on the NHS Choices website at www.nhs.uk.

Your GP Your GP’s surgery provides a range of services, including general medical advice and treatment, prescriptions, referral to a specialist or hospital (where appropriate), jabs and tests (for example immunisations, blood tests).

Remeamber to tell your GP if you have tried or are taking other medicines.

If you are not registered with a GP, you should do this as soon as possible. Luton residents can find out more about this on the Luton tPCT website, www.lutonpct.nhs.uk, or give us a call on 01582 528840.

Luton Walk-In Centre This is in Chapel Street, in the heart of Luton’s town centre, and is staffed by nurses. You can drop in without an appointment to see a nurse for advice, assessment and treatment of minor ailments and injuries such as cuts, bruises, minor infections, strains, sprains and skin complaints. Telephone 01582 556400 for the opening times.

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Luton and South Beds Urgent Care Service If you live in Luton and you urgently need medical help when the GP’s surgery is closed, you can call the urgent care line on 0845 6340 166. You’ll speak to a trained local professional who will arrange for you to have telephone advice, an appointment with a GP or a home visit, depending on your medical needs. The urgent care service also provides three treatment centres (two of which are in Luton) where you can go if you have an urgent health need – although it is better to telephone the urgent care line before you do this.

Accident and Emergency (A&E)/999 – do you need emergency hospital treatment?

If you or somebody else experiences severe breathing difficulties, loss of blood or suspected broken bones, go to an Accident and Emergency (A&E) department at a hospital or call 999 immediately.

The Luton and Dunstable Hospital has an A&E department. A&E departments are open 24 hours a day, 365 days a year and can assess serious injuries and provide emergency treatment.

Luton tPCT can supply the information in this article, in the form of a handy fridge magnet. If you live in Luton, and would like a free fridge magnet, please e-mail enquirieslpct@luton-pct.nhs.uk, or write to The Communications Manager, Luton tPCT, The Atrium, Burrs Place (off Park Street West), Luton LU1 3PD, giving your name and address.

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Is private health insurance too expensive?

Tim Smithers,Senior PMI Adviser, Medisearch Direct Ltd.

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s the NHS continues to dominate the headlines with stories of MRSA outbreaks and loss of personal patient information, more and more people are considering taking out private health insurance.

Most of them are in for a shock however, when they realise just how expensive having private healthcare can be. And with so many providers offering so many different policies, how do you know which one is the best for you and at the right price?

With so much choice available, it makes sense to obtain expert advice from people that really know the market. Specialist broker, Medisearch Direct, analyse and research the entire healthcare insurance market and provide free, independent advice on the best policy for your requirements. By looking at a vast range of options, Medisearch can often halve people’s premiums but without lowering the level of service or medical care they receive.

With cost being an important consideration for many people, there is an increasing need for policies that offer a suitable level of cover, without a large premium cost attached to it. Medisearch recognises this requirement in the market and as such, is always on the lookout for affordable and innovative products that meet the diverse demands and needs of their customers.

An example of one of the cost-effective products that Medisearch offers is PatientChoice Access. This policy provides cover for consultations, scans and hospital treatment. The client has the choice whether to use the monetary benefit payable to them to pay for private treatment or take a cash sum and be treated through the NHS. If the client chooses to have private treatment, any money that is left over once the hospital costs have been paid, is theirs to keep.

The policy also allows the customer to choose any hospital they wish for treatment, including going overseas. Martin Howell, Managing Director of Medisearch feels that clients should have choice when it comes to their healthcare, “There are many reasons why people want to have health insurance and having control over their treatment is one of the most important. If they need to see a specialist, they can arrange it quickly and at a convenient time and place to suit them.”

Monica Mitchell from London understands only too well the importance of having independent, impartial advice, “When I decided to look into taking out private

Tim Smithers

healthcare, I started looking on the internet and felt overwhelmed by all the information. There were so many different companies offering all these different products, I didn’t know what was right for me. When I spoke to Medisearch, they were so helpful and asked me what I wanted from a policy. They talked me through some schemes and really seemed to know what would suit me best. I ended up with the policy that I wanted, at a price I could afford to pay.”

As interest in the taking out private healthcare continues to rise, so does the complexity and cost of the policies available. As with all insurance, making sure your policy has the right level of protection is imperative. And the best way to make sure you have the appropriate scheme is by talking to specialists like Medisearch.

For more information, please call Medisearch on 0800 092 9963

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January 2008 - a time for change

Dr Draupadi Bhakta, Registered Dietitian Senior Lecturer in Human Nutrition London Metropolitan University

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anuary is traditionally the month for new resolutions, a time for change, and for most of us, this means a time to get fit and healthy. A few pounds put on during the Christmas period may take several months or even a year to lose and even small increases in excess energy every day (such as 50 kcals or a plain biscuit) can lead to a weight gain of about 5lbs. The problem is that often our new resolutions do not last longer than the month of January, but in these current times with a worrying obesity epidemic on our doorstep, it is very important that we continue to be vigilant about our weight, so that we can prevent long term health problems in the future.

South Asians and central obesity Obesity is a major problem for the whole of UK, today almost 25% of men and women fall into this category. It is predicted that by 2025 that one third of the population will be obese, and worryingly a similar trend is being seen in children.

How is this relevant to the South Asian community? Well the research, at present, shows that the South Asian community as a whole is less likely to obese than the general population. However, there is evidence that they have more fat around the middle, referred to as central obesity. This means that South Asians are more sensitive to weight gain and have a higher risk of developing diseases such as diabetes and heart disease. An easy way to see if you are at risk is to measure your waist circumference, and check against the table below.

Men Women

Increased risk 94 cm (37”) 80 cm (32”)

Substantial risk 102 cm (40”) 88 cm (35”)

Table 1: Waist circumference and associated risk for developing chronic diseases

Dr Draupadi Bhakta

environmental changes related to migration and or urbanisation, which includes diet and lifestyle.

The good news is that actually the traditional UK South Asian diet is relatively healthy. Most studies have shown that fat intake is not higher than the general population and that fibre intake is higher.

Dining out The best advice when eating out is to keep it all in moderation. When dining out at relative’s houses, it is a good idea to “fill up” on traditional foods such as chapattis, rice, vegetable curries and dahls and limit high calorie and high fat foods to a minimum such as pooris, pakoras, chewra and samosas. Some alternatives to the high fat foods have been suggested in the table below. You will notice that you can reduce the number of calories by almost half by choosing the healthier options. It is also important to keep an eye on the portions – it is a wellknown fact that “average” portion sizes in this country have increased dramatically over the last ten years.

There is also some new evidence that South Asians may have a higher total body fat compared to the general population for the same body mass index. There is no clear reason why South Asians are at more risk of central obesity, but this has been reported in studies in Popular dishes migrant South Asians in 1 small poori other parts of the world and 1 piece of burfi in those living in urban areas in India. It has been suggestKheer (made with whole milk) ed that some of this may be 1 small bowl of chewra due to genes and some to 1 medium-sized meat samosa

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kcal 188 146 128 200 190

Alternative suggestions 1 chuppati (no butter on top) Fresh fig Kheer (made with semi-skimmed milk) 1 small bowl of nuts and raisins 1 small leg of tandoori chicken

kcal 90 45 107 174 134

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Cooking tips Below are some useful cooking hints, which you can use throughout the rest of the year to help reduce your calorie, fat and salt intake, and increase your vegetable and fruit intake.

Try and cut down on the amount of oil you use.

Remember that all oil (groundnut, olive, sunflower) has the same number calories and a good tip is to try and use one tablespoon of oil for a family of four.

You will find that by using a non-stick pan will reduce the amount of oil needed during cooking.

Remove any extra oil after you have fried your spices and then continue cooking. Remove any additional oil left after cooking as well.

Remove the skin off the chicken as this contains most of the fat.

Use less or no salt in your cooking. You can make your food taste better by using more spices and herbs.

Make chapattis with less oil and avoid spreading with butter or ghee. If served fresh and hot your family will hardly notice the difference. Also using chapatti flour with more whole-wheat (No 3 and No 4) will increase your daily fibre intake signifi

cantly.

Try and avoid adding butter, margarine or oil when cooking rice.

Add extra grated or chopped vegetables to raitas, to increase your vegetable intake.

Try and replace sevyiaan, kheer and mithai with freshly cut up fruit.

Remember paneer is a full fat cheese, and so use either in small quantities or try making your own with semi-skimmed milk.

Dahl is naturally high in fibre, low in fat and high in protein. Try and have dahl at least two or three times a week.

Add more vegetables to curries and cut down the amount of chicken, lamb or mutton.

Try and eat more fish. Fish is good for the heart, and may help prevent other diseases as well. Oily fish like salmon, tuna, and mackerel are particularly good.

Increasing physical activity Increasing your physical activity will also help reduce your weight. Making small changes in your daily lifestyle, like regular walking, taking up gardening as a hobby or walking up the stairs rather than taking the lift will all help keep the muscles and joints working as well as burn excess calories. Let’s make January a time for change.

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Giving the gift of giving up Alexia Patterson, NHS Smoking Helpline Adviser

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any smokers don’t realise that their habit affects loved ones who worry about their health. Quitting smoking is not only the single best thing you can do for your health, it can also be a gift for those who care about you most. It can take up to six or seven quit attempts to finally beat your habit – so don’t stop trying.

A smoking issue Smoking contributes to numerous life threatening diseases, many of which are more pronounced within Asian communities. For example, 40% of Bangladeshi males and 29% of Pakistani males smoke compared to the male national average of 26%.

Worryingly, these groups have also been shown to possess relatively poor knowledge concerning the link between cigarette smoking and disease. For example, 22% of Bangladeshi men and 20% of Pakistani men believe smoking has ‘no effect’ on their current health, compared to 12% of the UK as a whole.

The harsh reality is that every year, an estimated 106,000 people in the UK die as a result of smoking.

In fact, evidence shows that smoking harms nearly every organ of the body. It is the cause of 90 per cent of lung cancer cases and is linked to many other cancers, such as cervical or kidney cancer, as well as emphysema, bronchitis, asthma and other respiratory diseases. Other health risks associated with tobacco use include oral, throat and neck cancer, as well as heart attacks, stroke, other cardiovascular diseases and infertility. Smoking can also cause coronary heart disease - Asian women have a 51% higher chance, and Asian men a 46% higher chance, of dying prematurely from a coronary heart disease than the general population.

Dr Abdullah Shehu, Chair of the Health and Medical Committee of the Muslim Council of Britain believes the Muslim community should be doing everything possible to combat the problems related to tobacco consumption. "Smoking is a serious health issue for Asian communities”, says Dr Shehu, “Muslims in particular suffer from higher rates of respiratory symptoms, heart disease, severe chest pain and long-standing illness than Sikhs or Hindus”.

It’s not just smoking that can affect your health There are many ways that tobacco can be consumed, including chewing it in the form of paan or smoking it

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Alexia Patterson

through a waterpipe. But as Dr Yumiko MochizukiKobayashu, Director of the WHO Tobacco Free Initiative stresses, “Tobacco can kill in any guise, regardless of whether you smoke it, chew it or inhale it through a waterpipe”.

Chewing paan is a strong tradition among many Asian communities. Indeed, rates of chewing tobacco are much higher among many Asian communities than the rest of the UK population – 9% of Bangladeshi men and 16% of Bangladeshi women chew tobacco. Many people don’t realise it, but chewing tobacco greatly increases your chance of contracting oral cancer, and the habit is particularly prevalent amongst Bangladeshi women aged 55 and over with 29% of this group admitting to the habit.

Using waterpipes to consume tobacco is also dangerous. According to a recent World Health Organization study, a typical one-hour session of hookah smoking exposes the user to 100 to 200 times the volume of smoke inhaled from a single cigarette.

Even after passing through the water, the tobacco smoke produced still contains high levels of toxic com-

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pounds, including carbon monoxide, heavy metals and cancer-causing chemicals (carcinogens). Hookah smoking also delivers significant levels of nicotine. On top of this, waterpipe users are at an increased risk of mouth and gum disease as well as tuberculosis and hepatitis.

A study in Saudi Arabia found that the relative risk for periodontal (gum) disease increased by 5-fold and 3.8fold in waterpipe and cigarette smokers respectively, compared to non-smokers.

So how do I give up?

Research shows that 70% of smokers would actually like to give up if they could, but like anything else, to be successful you need to put time and effort into the attempt and make sure you get the right support and encouragement. Stopping smoking may be one of the most difficult tasks that you set yourself and you will need to learn new habits and coping strategies: Be prepared: First and foremost, don't try to stop immediately – stopping smoking requires preparation.

Set yourself a quit date sometime in the future, like after your birthday or the end of a holiday. By planning for, and building towards a quit date you have time to plan practical ways to cope with giving up. It’ll also be a chance to get used to the idea of not being a smoker. Asking friends and family for their support can really help.

Be patient: Withdrawal symptoms are often the cause of relapses. They are caused by nicotine leaving the body, and can be different for everyone. Be kind to yourself - there is no need to go through a period of “cold turkey”, there’s plenty of free help available.

Visit you local NHS Stop Smoking Service: Local NHS Stop Smoking Services offer ongoing free face-toface support and advice. There are over 170 throughout the country, offering a range of services including oneto-one meetings and group discussions with trained advisors.

Get support: You can speak to a GP about using Nicotine Replacement Therapy (NRT), Zyban or Champix which help you fight the cravings you get when you stop smoking. There are several different NRT options, including chewing gum, patches, varenicline, or lozenges, which are all available on prescription. You can also visit your free local NHS Stop Smoking Service for group or one-to-one sessions with trained Stop Smoking Advisers who can help you through the trials of beating the dreaded weed in a step-by-step programme. Smokers are up to four times more likely to give up successfully if they use their local NHS Stop Smoking Service together with Nicotine Replacement Therapy than relying on willpower alone.

Quit Together: If you’d love to give up but just seem to be far too busy, the Together programme maybe for you. You don't even need to leave your home. Information packs, supportive texts, email messages and phone calls can be sent to you at those crucial moments when going back to smoking seems like

the only way through. You can find out more about the programme at the gosmokefree.co.uk website.

Get support from your friends and family: If you need that extra incentive to ditch the cigarettes, why not do it for a good cause and help raise money for a charity of your choice? You can now quit online and get your friends and family to sponsor your quit attempt. Just log on to www.justgiving.com/smokefree and register. Simple as that.

Treat yourself: At today’s rates, a 20-a-day smoker will spend £36,500 over the next 20 years. Quitting doesn’t need to be a chore - congratulate yourself each day you stay quit and put the money saved towards a special treat. The cash can soon build up and you might surprise yourself as to what you can save - a 20a-day smoker could afford a £210 digital camera after just 6 weeks.

To find out about the range of support the NHS has to offer to help you stop smoking you can visit www.gosmokefree.co.uk or call the NHS Smoking Helpline on 0800 169 0 169. To find your local NHS Stop Smoking Service and to get advice in five different languages, you can call the NHS Asian Tobacco Helpline (open Tuesdays 1-9pm with messages taken at other times), which provides a dedicated, confidential and free advice service on how to give up smoking cigarettes, 'bidi' or the hookah as well as chewing tobacco and tobacco in paan.

The phone numbers are: 0800 169 0 881 (Urdu) 0800 169 0 882 (Punjabi) 0800 169 0 883 (Hindi) 0800 169 0 884 (Gujarati) 0800 169 0 885 (Bengali)

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Health

Care Medical Tourism

S Jagadeesan, Minister Economic High Commission of India in London

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edical tourism has gained momentum in India over the past few years, a trend underpinned by India’s low-cost advantage and the emergence of new high-quality healthcare service providers. About 180,000 patients arrived in 2004 from across the globe into India for medical treatment. The medical tourism market in India, estimated at US$ 333 million in 2004 grew by about 25 per cent and is predicted to become a US$ 2 billion-a-year business opportunity by 2012. India is seeing a surge of patients from developed countries as well as from countries in Africa and South and West Asia that lack adequate healthcare infrastructure.

The emergence of low-cost, high value specialist medical care territories in India has been noteworthy. For instance, New Delhi has emerged as a prime destination for cardiac care, as has Gujarat. Similarly, Chennai has established a niche for quality eye care, while Kerala and Karnataka have emerged as hubs for state-of-the-art ayurvedic healing. These “medical hotspots” are beginning to witness an influx of health tourists from non-traditional geographies. Among others, foreign health travellers to India comprise a large number of Non Resident Indians (NRIs).

S Jagadeesan

Overburdened health infrastructure & high costs in the West, a key driver for looking at India The healthcare systems in Europe and the United States are under severe pressure; particularly the National Health Service (NHS) in the UK, which has a long list of patients waiting for over a year for surgery. In the US the healthcare crisis has a different dimension. Around 50 million citizens are uninsured, with even the insured having to pay dearly for treatment. Further, the shortage of paramedical professionals such as nurses has aggravated the situation. Patients from the US are now regularly beating a path to India, as many of their insurance companies have entered into tie-ups with private Indian hospital chains.

India’s low cost of medical care, a strong value proposition India offers highly cost-competitive medical treatment and technological advances in areas such as cardiology, cosmetic and orthopaedic surgery, dentistry, eye care and preventive health checks. India offers world class cardiac bypass surgery, hip replacements, organ transplants, cosmetic, dental surgery and vision correction. Costs of comparable treatment in India are on average one eighth to one fifth of those in the West. For instance, a cardiac pro-

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cedure costs anywhere between US$ 40,000 - 60,000 in the United States, US$ 30,000 in Singapore, US$ 12,000 - 15,000 in Thailand and only US$ 3,000 - 6,000 in India. Likewise, the associated costs of surgery are also low.

India has also emerged as a centre for several cutting edge surgical treatments. Eye care, in fact, is one area where India has a distinct advantage - it has more Lasik centres than some developed countries.

With diagnostic tests in India being inexpensive, India also has the potential to emerge as a hub for preventive health screening. At a private clinic in London a health check-up for men that includes blood tests, electrocardiogram tests, chest X-Rays, lung tests and abdominal ultrasound costs around £350. In comparison, a comparable check-up at a clinic operated by Delhi-based healthcare company Max Healthcare costs US$ 84. A Magnetic Resonance Imaging (MRI) scan costs US$ 60 at Escorts Hospital in Delhi, compared with roughly US$

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700 in New York. The overall cost of travel and treatment in India is still far less than the expense of just the medical treatment in many western countries.

India’s value proposition goes far beyond cost; quality second to none Cost is not the only factor weighing in India’s favour.

Escorts Hospital, for instance, is one of the only handful treatment facilities world wide that specialise in robotic surgery. The death rate of coronary bypass patients at Escorts is 0.8 per cent. The overall success rate of cardiac bypasses is 98.7 per cent in India, as opposed to only 97.5 per cent in the United States.

India’s healthcare industry is thus both competitive on cost and quality. It is widely believed that there is not a single surgery/procedure, which is done abroad but cannot be done in India.

Apart from being in step with changing healthcare delivery technology, leading Indian medical care facilities are increasingly complying with stringent quality standards and queuing up for international accreditations. For instance, Apollo Hospitals has received Joint Commission International (JCI) accreditation from the Chicago-based Joint Commission of Accreditation of Hospital Organisations (JCAHO).

With an increasing number of Indian hospitals offering services at the cutting edge, there is a growing acceptance of India-based medical care among global insurers. For instance US-based private health insurers Blue Cross and Blue Shield and British health insurer Bupa now insure clients treated at a number of private hospitals in India.

India’s private healthcare sector braces up to the medical tourism opportunity Due to the surge in medical tourism, some of the major corporate hospital groups in India such as Apollo, Fortis, Max, Wockhardt and Manipal have made significant investments in setting up state-of-the-art hospitals in major Indian cities. Fresh healthcare capacities that are coming up will help sustain the trend. For example, Dr. Trehan, one of India’s ace cardiac surgeons is establishing a MediCity on the outskirts of Delhi with the single objective of promoting medical tourism. The US$ 250 million project proposes to integrate super specialities such as cardiology, neuro-sciences and oncology under one roof with 2,000 beds.

Further, hospital chains are offering special packages, which include airport pickups, visa assistance and boarding and lodging. Apollo Group of hospitals for instance has a full fledged international patients department, which offers assistance to patients from the time they land in India to the time they depart. Apollo has about 14 healthcare facilitators, besides tie ups with two travel agents. Similarly, Escorts Hospital (now a part of the Fortis Group) has an in-house hospitality department that provides all pre and post-treatment assistance, including receiving patients at the airport, arranging

accommodation and travel packages to various tourist destinations in the country.

Tie-ups and alliances are taking interesting forms.

Manipal hospital has tie-ups with the governments of Tanzania and Mauritius. The health expenses of Tanzanians and Mauritians in Manipal Hospital are covered by the respective governments. Further, the hospital’s agreements with foreign travel insurance providers give it significant international exposure.

Government Initiatives Economic incentives have been introduced towards upgrading existing infrastructure to make India a global healthcare destination. These include tax sops to financial institutions lending to private groups setting up hospitals with 100 or more beds, and an increase in the rate of depreciation from 25 per cent to 40 per cent for life-saving medical equipment.

A new Category of Medical Visa has been introduced which can be given for a specific purpose to foreign tourist coming to India for medical treatment. Also special visa can be issued to attendant/family members

Medical tourism is the next big success story out of India State governments, private hospital groups, and even travel agencies have all caught on to the trend. Leading Indian travel houses like Sita and Kuoni have launched tie-ups with overseas players that focus on medical tourism. The Karnataka Government is setting up Bangalore International Health City Corporation, which will cater to international patients for a wide variety of health care products and treatments. The Asian Heart Institute at Mumbai’s Bandra-Kurla Complex, offers state-of-the art facilities for all types of heart complications. It has been set up in collaboration with the Cleveland Institute, USA and offers ‘five-star’ services at a reasonable cost.

A number of foreign companies are already setting up registries in India. Registries are centres where the first 500 surgeries are conducted after a medical device or surgical treatment has been approved by the US Food and Drug Administration. Baxter did it for its medicated stents while Bausch & Lomb has set up a registry for zyoptic surgery.

India offers a unique basket of healthcare services that is difficult to match by other countries. Apart from the international tourists visiting India for the urgent or elective medical procedures, the number of tourists visiting India for reasons associated with wellness and healthcare is also increasing. Although there are no estimates related to the tourist traffic of this segment, or the estimated revenue generated by this sector, it is expected that this segment of healthcare tourism also has greater potential considering the growing acceptance of Indian systems of therapies, such as Ayurveda, and healing practices such as Yoga.

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Beauty

Ayurveda‌.Holistic Beauty Care

Shahnaz Husain

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ndia is a country where traditions have existed side by side with modern technological advances. In fact, the character of modern India is firmly rooted in a rich cultural past. This feature is evident in our ancient healing system of Ayurveda, which continues to flourish. Today, Gem Therapy Range have taken the international marAyurveda has found a prominent place, both in health kets by storm. and beauty care. The ancient treatments have been Neem (margosa) is one of the most versatile plant viewed in the light of modern scientific research. Today, products. Since the ancient times, Neem with naturalism and the concept of total leaf infusions have been used to cure skin well-being sweeping the globe, the Indian diseases and are still used to relieve itchdisciplines of Yoga, Meditation and ing, soothe rashes, create a germicidal Ayurveda are being adopted world wide. environment and clear inflammatory conAyurveda literally means “the science ditions. Neem contains organic sulphur of life.� Established 5000 years ago, by the compounds, which have a powerful and sages of India, it is the oldest and most versatile healing action. developed system of holistic healing in the Herbs like Shikakai (acacia concinna) world. It is not merely a system of healing. and Arishtak (Sapindus trifoliatus) have It is an entire way of life. Ayurveda makes been traditionally used for washing the use of plant ingredients and other natural hair, due to their powerful, yet gentle, substances, according to individual needs. cleansing action. Amla (Embelica officiIt contains the painstakingly recorded nalis) is another popular ingredient. The knowledge of thousands of plant products ancient physician Charaka referred to amla and natural substances, with their specific as an ingredient that delays ageing, effects and benefits. Yoga and meditation because of its high Vitamin C content. It are closely related to it, because they help Shahnaz Husain is said that the Vitamin C content of Amla to keep body and mind healthy. We have is so stable that it is resistant to heat. applied Ayurveda in beauty treatments and found that it Trifala, a combination of three herbs, has varied uses, has the ideal answers to the demands of modern cosfrom washing the hair, removing dandruff and promoting metic care. Ayurveda not only helps in treating skin and hair growth, to curing hair problems, but is ideal for general beauty care. Being eye ailments. It cona holistic system, it takes diet, exercise, stress control and sists of Amla, Haritaki lifestyle into consideration.

(Terminalis chebula) Today, we have the benefit of scientific research and Vibhitika into the medicinal properties and traditional uses of (Terminalis belerica).

Ayurvedic ingredients. The ingredients that have been Bilva (Indian Quince), selected for our formulations not only have specific curHibiscus, Amla and ative properties, but offer an element of safety, as they Brahmi (Indian have shown a lack of harmful after-effects and reactions.

Pennywort) have also In fact, many of been used in hair care. them help to soothe Brahmi helps to control the skin and cure stress-related probinflammatory condilems, as it has a calmtions. We have not Flower Power ing effect on the only used plant nerves, apart from ingredients, but other beneficial properties. other natural subSandalwood is perhaps one of the most common stances too, like ingredients that have been used in skin care, because of gold, pearl and preits versatility. It soothes the skin and beautifies it and is cious gems. Our 24 an ancient Indian cosmetic ingredient. It has powerful Carat Gold Products, germicidal and antiseptic properties, while the exotic perDiamond Collection, fume is said to have a relaxing effect on the nerves. Tulsi Pearl Range, AstroPearl Cream (Holy Basil) has so many medicinal uses that it has been

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Health & traditionally venerated and worshipped in India. Modern research has revealed that it helps to purify the air, apart from its soothing and curative actions on the skin and scalp. Rose has also been one of the most common cosmetic ingredients. Oil of rose is said to have originated in India. The Mughal Empress Nurjehan is credited with its discovery. Apart from helping to tone the capillaries, improve blood circulation and help skin texture, the fragrance of rose has a calming effect on the nerves too. It is used in stress-related skin and hair conditions, along with sandalwood, jasmine, orange flower and brahmi.

Ingredients like sandalwood, basil (tulsi), mint (pudina), margosa (neem), turmeric, clove, eucalyptus, ashwagandha (winter cherry), manjishtha (Indian madder), khus (Vetiver), carrot seed and many others have been used in our formulations.

Such ingredients have powerful healing properties and many benefits for skin and hair care. In fact, they have definite protective, preventive and corrective actions. They also contain vitamins, minerals, enzymes and other valuDiamond Skin Rejuvenating Mask able substances, which are imperative for the health of the skin and hair. Herbs help to improve the normal functions of the skin and scalp, including that of cell renewal. Thus they have the power to revitalise and rejuvenate.

An interesting fact about natural ingredients is that the fragrances of many herbal and floral extracts have a calming effect on the nerves. It seems that nature can cater to all our needs. Fragrances of rose, sandalwood, brahmi, jasmine, lavender, etc., are known to have a calming effect and help stress-related skin and hair problems. Today we know that mind and body are closely related. Stress and anxiety can trigger off many beauty problems, like acne, hair loss and dandruff. Natural fragrances and aromatic oils can induce relaxation and help to treat skin and hair problems.

For centuries, Ayurveda has also been using metals and gems as medicines for specific ailments. Like herbs, these elements are also a gift from nature, creating harmony of body, mind and spirit. Gold is one of the softest metals and is easily absorbed by the skin. It helps to rejuvenate the skin and can even reverse oxidation damage.

Pearl has powerful nutritive elements and influences the transfer of melanin. Diamond, the best known and most coveted of all gemstones, also has highly potent healing and rejuvenating properties. According to Ayurvedic texts, it is said to infuse “prana” or “life-force” and increase longevity even in some life-threatening diseases. It was also used to reverse the effects of premature ageing. Used on the skin, it is said to have age-defying and powerful rejuvenating effects, controlling the visible signs of ageing.

Beauty

As leaders in product innovation, the Shahnaz Husain Group has evolved more than 350 formulations for general care and the treatment of skin and scalp problems. Based on “Care and Cure”, the product ranges include entire lines of therapeutic formulations, which reflect a deep understanding of the demands of protective, preventive and corrective care.

They have no exact equivalents in the market. Apart Shayouth Wheat-Germ Tulsi Balm from the legendary Shahnaz Herbal Range, there are ranges based on specific extracts, like Flower Power, Neem Range, Honey Health, Himalayan Herb, Sun Range (sun-block products), Veg Power. A line of Ayurvedic health tonics, medicinal formulations (like pain relieving balm, blood purifiers, cough syrup, Isabgol), food supplements, herbal drinks, herbal teas, immunity enhancers, medicines and Aromatherapy essential oils, are also part of the repertoire. The Group has launched some revolutionary products in modern skin-care, which include the 24 Carat Gold Range, Pearl Cream and Mask, Oxygen Cream, Astro-Gem Therapy range and Diamond Collection.

Nature’s Gold Beautifying Mask

I have always believed that India has so much to offer the rest of the world by way of her herbal heritage.

From one herbal salon to a global chain of salons, spas, shops and beauty training institutes, it has been a phenomenal journey. We recently achieved an Ayurvedic coup when a Shahnaz Ayurveda Aesthetic Clinic opened on Harley Street, London. It is the biggest achievement in the 5000-year old history of Ayurveda. Today, Ayurvedic beauty treatments have become an important component of cosmeseuticals. For me, it is a dream come true to see the world wide recognition of Ayurveda. I strongly believe that Ayurvedic beauty care can lead the billion dollar international cosmetic industry within the next decade. It has been tested by the most exacting test of

all…..the Test of Time!

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Overview of Cosmetic Surgery

Mr J D Frame FRCS FRCS(Plast) Consultant Plastic and Reconstructive Surgeon

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here is a constant, incessant rise in the number of cosmetic surgery and non-surgical aesthetic procedures in the United Kingdom. The U.K. is probably the most expensive country in the world for cosmetic surgery. In the last ten years it has continued to play “catchup” with other nations, with regard to innovative techniques and advancement of the speciality. Latest official figures, from the British Association of Aesthetic Plastic Surgeons, record twenty two thousand and forty one procedures, a thirty five per-cent increase from the 2004 audit. In the U.S.A. eleven million procedures are performed each year. Other specialities have become involved, providing services in this expanding, lucrative market. Care must be taken in choosing the right surgeon. Inevitably, there will be regulation of the Aesthetic market, with fully trained, accredited specialists, assessed by appraisal and outcome, being allowed to carry out this type of work.

The rise in non surgical cosmetic procedures includes Botulinum Toxin, injectable fillers, skin resurfacing procedures, micro-pigmentation, pigment removal and hair removal. Best practice guidelines are to not allow “ Botox parties “ or any form of invasive procedures without proper consultation. Issues such as practitioners administering Botox without seeing an accredited doctor, using “remote” prescriptions, are banned by the general nursing and medical councils.

Figure 5a

For the purpose of this article, and specifically the Asian population in the U.K., I can only go on my twenty five years experience as a Plastic and Cosmetic Surgeon, in what is a very busy cosmetic surgery practice, now centred in Chelmsford, but which has involved fifteen years in Harley Street, Hertfordshire and Essex.

Aesthetic Surgery still largely remains the domain of white, caucasian women aged between eighteen and

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Asian Voice - 2008 Gujarat Samachar

sixty-five years of age.

The commonest procedures performed are Breast Augmentation (enlargement), Blepharoplasty (eyelid surgery) and MiniFacelift (jowels and n e c k - l i f t ) .

A b d o m i n o p l a st y, Breast Reduction, Liposuction, Rhinoplasty and autologous fat relocation are slightly less freMr J D Frame quently carried out.

There is an increasing number of Inner Arm and Inner Thigh reductions as a result of weight loss programmes. In my view, the increasing market is the result of various influences but, essentially, the individual recognises something they would like to change, seeking opinions from family and friends.

The original “thoughts” were probably created by friends or media advertising through glossy fashion journals, gossip magazines and indeed “Bollywood”.

Celebrity gossip is a major influence on younger and middle-aged women, as is fashion including hairstyle.

There is undoubtedly a rise in the number of Asian women seeking advice on aesthetic procedures, particularly second and third generation young women, who have become prone to external influences and immune to the respected opinions of the older generation.

The main objective of cosmetic surgery is to increase the self confidence and improve the appearance of a normal individual, in the least invasive way, with the least amount of risk. If at all possible, the responsible plastic surgeon should actively dissuade from proceeding to surgery. Professional “well being” coaches can be amazingly beneficial in avoiding surgery. Often an immature person needs to “grow up” before making informed decisions. Consider the quote from the iconic Kylie Minogue, in 2007, “ My body’s not what it was, but it’s the body I’m in”.

Asian skin is generally prone to poor scar formation and variable hyper- or hypo-pigmentation. Liposuction is probably the commonest procedure carried out in the Indian sub-continent, but this does not address the resultant slack skin that needs to be excised. Non-surgical pro-

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cedures, such as hair removing laser therapy, have become increasingly popular. Probably the most common procedure in Asian women is Abdominoplasty. It nearly always follows completion of family. There are now increasing numbers of Asian women seeking breast augmentation and rhinoplasty, in my opinion as a result of multicultural integration.

How to choose a surgeon Regardless of where you live, there is always a reputable private hospital nearby that covers both medical and surgical admissions. These hospitals are host to N.H.S. consultants who are fully accredited and insured for medical indemnity. The hospitals will have a list of practising plastic surgeons but they will probably not tell you who is the most appropriate for you to see. Your general practitioner will know the surgeons and, if so, you should take your doctor’s advice and be officially referred. You can check the credentials of the plastic surgeon online and/or by contacting the British Association of Aesthetic Plastic Surgeons (BAAPS) or the British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS). All the plastic surgeons should be members of BAPRAS and those more cosmetically inclined will be members of BAAPS, or even the International Society of Aesthetic Plastic Surgeons (ISAPS). The General Medical Council (GMC) will have details of accreditation in Plastic Surgery.

Friends, relatives and close acquaintances can often reassure you about a particular surgeon but it is important that you are an appropriate patient for an appropriate procedure, in an appropriate environment with appropriate aftercare. In the case of Springfield Hospital, for example, there are seven plastic surgeons with regular operating lists, and a further eight plastic surgeons with admitting privileges. All of these surgeons are members of BAPRAS and three are members of BAAPS. There is a designated Plastic Surgery ward and plastic surgery nurses with aesthetic diploma qualifications to look after you. This is in contrast to many well advertised units in London with visiting, overseas surgeons and no accredited specialist nurse care. A regular number of celebrities travel from all around the U.K., and abroad, for cosmetic surgery at Springfield.

Cosmetic Tourism There is undoubtedly an increasing market for cosmetic surgery abroad, mainly because it appears to be cheaper, with a holiday thrown in. There are obvious, inherent risks, starting with deep vein thrombosis and pulmonary embolism, minor or major complications such as bleeding infection and wound breakdown, but there is also no comeback if dissatisfied with the outcome. I see cases of serious iatrogenic complications, that need major reconstructive surgery to put right (Fig 1.). Deaths following liposuction, blindness after blepharoplasty and wound sepsis, seroma formation and wound breakdown after abdominoplasty have all been reported. If there are surgical problems which then have to be addressed at home, then the total costs are hugely expanded.

Figure 2

Common cosmetic procedures Abdominoplasty After childbirth, particulary on multiple occasions, the anterior abdominal skin often loses its tone and elasticity. In addition, the abdominal wall muscles weaken. An abdominoplasty removes any redundant, overhanging skin, tightening the muscles to give a better overall appearance whilst dressed and undressed, after the scars have matured. There are, however, significant risks such as seroma collection, unsightly scars and permanent skin numbness. There are major advantages in addition to cosmesis, including improvement in personal hygiene and relief of backache. (Fig 2) Breast Augmentation Younger Asian women are looking at breast augmentation by the use of silicone implants or by fat transfer, from the hips or abdomen, to the breasts. Both procedures have different benefit and risk factors. Implants, in theory, can go hard, but this is exceptionally rare these days; misshape; rupture, ripple or displace. Different shaped implants will give different cosmetic results. The end shape is dependant upon skin, breast soft tissue volume and support, the type of implant chosen and probably, and most importantly, the symmetry and shape of the thoracic skeleton, which is the foundation upon which the implants sit. Nipple sensation can also be impaired.

There is no evidence that the auto immune scare with silicone implants (1992) occurs with modern implants. (Fig 3.)

Autologous fat has many advantages and few limitations. It offers fat harvest from an area that may be Asian Voice - 2008 Gujarat Samachar

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Beauty As individual procedures, or combined, these have become increasingly popular in all age groups, from mid30’s onwards. Upper eyelid hooding and fatty swelling in the lower eyelids can be improved with low risk techniques. A vertical and vectored pull mini-facelift usually gives immense benefit in appropriately selected patients.

The risks are few and the benefits high. (Fig 4) Breast Reduction Large breasts are a great burden to many women. They can cause social embarrassment, back pain, sweat rash and other problems. This is probably the most rewarding of all procedures in the aesthetic repertoire. Sometimes liposuction alone will suffice (Fig 5) (Fig 5a), otherwise scars around the nipple, vertically or as an anchor shape are the usual result. Postural relief is immediate, as is self confidence in the woman. Downsides include poor wound healing and scars, with potential for nipple numbness and asymmetry.

Rhinoplasty

Figure 3 “spare” and there is no foreign body or risk of silicone related granulomatous disease. However, the fat transferred may not survive in its entirety and secondary procedures may be needed. The scars, however, are tiny and there is no implanted look. Up to 200mls is considered a safe transfer of fat; small silicone implants vary between 200mls and 250mls. (Fig 3a)

Blepharoplasty and Mini-facelift Figure 6 The commonest reason for seeking a rhinoplasty procedure is to reduce a hump that is obvious in profile. Tip adjustments are also fairly common. Great results can be achieved but it is immensely important to select the right patients for this procedure. One should turn away those who are dysmorphic or need the help of other professionals. The nose is obviously the most immediately visible part of the face. A good outcome is essential. In appropriate cases this is an immensely rewarding operation but usually needs a high level of skilled peri-operative care and counselling. (Fig 6) Summary It is anticipated that Aesthetic Surgery will continue to become ever more popular. The choice of an accredited plastic surgeon and accredited medical staff, with an accredited facility with specialist nurses will help in the patient’s journey with cosmetic surgery.

Figure 4 24

Asian Voice - 2008 Gujarat Samachar

(Mr.J D Frame is a member and on the council of the British Association of Aesthetic Plastic Surgeons (BAAPS).

The Association was established for the advancement of education in, and the practice of, Aesthetic Plastic

Surgery for public benefit.)

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Girl power hits the operating theatre

Delia Nield

T

he cosmetic surgery industry continues to boom and the majority of those having a nip here and a tuck there continues to be female. Many women can be put off by the idea of bearing all to a male cosmetic surgeon – especially if the procedure they are considering is one of an intimate nature. For this reason, leading London plastic surgeon Dalia Nield launched an all female operating theatre team.

Mrs Nield, who has worked in cosmetic and reconstructive surgery for over 20 years and is a member of the British Association of Aesthetic Plastic Surgeons (BAAPS), says she noticed a lot of women were coming to her for breast work because she was a woman.

“Women seem to feel comfortable in my presence and feel I will understand their situation because I am a woman. I am of the belief that gender does not come into it as a member of an operating team – just whether you are good at your job – but it matters to patients and if women are more at ease dealing with an all female team they should be able to access that service. I decided it was a logical extension for us to offer an environment where women can feel understood and in comfort, if that is what the patient requires,” says Mrs Nield.

Mrs Nield found the all female team to be very popular with those having an intimate procedure done, such as vulvoplasty or breast work, and for those who require it due to religious beliefs and culture.

The launch of this service was a godsend for Amardeep Singh*, 39, of South London. The fear of bearing all to a male plastic surgeon had put her off seeking help for something that was beginning to rule her life. The married mother-of-two had put off smear tests for years for fear of what the nurses might think and never allowed herself to be seen entirely naked even by her husband.

Says Amardeep: “I felt abnormal for years and couldn’t even bring myself to walk from the bathroom to my bedroom naked after a shower, I’d always put my knickers on first. It got to a stage where I didn’t want to put up with the way I felt anymore, so when I saw the article I called and booked a consultation.”

Amardeep felt so at ease on meeting Dalia and her nurse. She adds: “Dalia and her friendly female staff gave me the courage to explain that I hated the size and shape of my vulva and felt ashamed of it. I had also been poorly stitched after the birth of my second child. Upon examination Dalia assured me she would be able surgically remedy what I considered to be my abnormalities. My sense of relief was overwhelming as I had lived with what felt to me like a ‘guilty secret’ for years.

Amardeep went through with the vulvoplasty oper-

Delia Nield

ation in July of last year – and is thrilled with the results.

“When I came around from the anaesthetic the first thing Dalia said to me was that the operation was a huge success and I looked fantastic – it was such a relief. I felt she’d given me a lease of life and that finally I was normal ”.

Mrs Nield says: “We’re thrilled with Amardeep’s outcome. That is the beauty of this service – the idea of exposing such an intimate area to a man, even a doctor, can be off-putting for many women and this can apply to any aesthetic procedure.”

The all female team comprises Mrs Nield, female anaesthetists and female theatre staff. Mrs Nield practises at The London Clinic and is an Honorary Consultant to St. Luke's Hospital for the Clergy. *The name has been changed to protect the identity of the case study.

Dalia Nield FRCS

(ed)

consultant plastic surgeon and member of the British Association of Aesthetic Plastic Surgeons (BAAPS) and the British Association of Plastic, Reconstructive and Aesthetic Surgery (BAPRAS).

The London Clinic, 20 Devonshire Place, London,W1G 6BW. Tel: 0207 935 4444.

Email d.nield@lonclin.co.uk. www.dalianieldplasticsurgeon.com Asian Voice - 2008 Gujarat Samachar

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Orthodontics - Asians aim for that perfect smile

Dr Asif Chatoo, Specialist in Orthodontics The London Lingual Orthodontic Clinic

T

he increased influence of Bollywood, the growing importance of looking ones best for career enhancement and the ongoing interest in celebrity culture have all contributed to the rise of adults seeking orthodontic treatment.

In my clinic, for example, we have seen a significant rise in adult patients over the last twelve months, seeking orthodontic treatment for a variety of reasons from wanting to look their best professionally to looking for a confidence boost. We have also seen a rise in older patients, who missed out on orthodontic treatment in their youth.

treatment you will need to see a hygienist every 3 months and visit your dentist every 6 months.

It will be necessary to make changes to your diet during treatment to prevent breaking your brace. Discomfort of the teeth, irritation of the tongue and mild speech disturbances are all transient effects at the start of treatDr Asif Chatoo ment. This normally last for 3-5 days after the braces have been fitted. Pricing for lingual braces depends on the type, length and complexity of treatment required. Generally the fees for treatment are between £4,000.00 -£9,000.00.

Male and female patients come to us to have lingual braces fitted for a variety of reasons. Some have sought treatment to improve the appearance of their teeth. The reason may be a simple quest for a perfect smile, in preparation for a once in a lifetime occasion such as marriage or because they want to do something special for themselves and their overall appearance.

Maybe they have lost weight and now want perfect teeth to go with their new physique.

BEFORE For those who are getting orthodontic treatment after they leave school, there has been a move away from the obvious ‘train track’ treatment as exemplified in the ‘Ugly Betty’ and ‘Jassi Jaissi Koi Nahin’ TV series. Instead, we have seen Asian patients look to lingual or ‘invisible’ braces, primarily because they are so discreet.

Lingual braces are attached to the inner surface of the tooth, inside the mouth, so are invisible from the outside, unlike traditional ‘train tracks’. Professionals and older patients prefer this treatment because they can be confident in the fact that no-one knows they are wearing braces. There is also no age limit for using lingual braces as an orthodontic treatment.

For those who are not familiar with Lingual braces, they use the latest computerised technology to make precision attachments that are placed on the inner surfaces of the teeth. During treatment patients need to see their orthodontist every 4-6 weeks to have their braces adjusted. The treatment time does vary depending on the complexity of the treatment and may take anywhere form 6 – 24 months.

Healthy teeth and gums are essential for successful treatment with Lingual Orthodontics. It is important that you see your dentist and a hygienist before you start treatment with lingual braces. During

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AFTER One of my patients, Ms. Bhiarri Patel, a director of a care home who is in her 30s, opted to have her teeth straightened after a childhood accident left her with very irregular front teeth which made her very self-conscious. She wanted to improve her smile but did not want conventional braces that were visible.

Lingual braces satisfied her desire to change her smile with braces that could not be seen. After her treatment she said, “I smile so much more and it really has increased by self confidence”. Proof that it is never to late to change the smile you have to the one you really want!

London Lingual Orthodontic Clinic is the only clinic in the UK that specialises in Lingual Orthodontics.

http://www.londonlingualbraces.com.

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Ayurvedic Nature Cure, Cure for Hair Loss R

eceding hair and baldness can occur for a variety of reasons (nutrition, medicines, over exposure to the sun or poor hair care) and can greatly affect self confidence, often leading to depression and social withdrawal.

In most people, active hair follicles still exist in the scalp even after partial or complete hair loss. They merely lack enough of the proper nutrients in order to return to full hair growth.

We offer the most effective products and treatments available for hair loss and alopecia. Using our products for just five minutes each day stabilises hair loss within 4 days and stimulates the growth of new hair.

Continuous use of our products will solve the problem permanently.

Ervamatin Hair Lotion - (200ml) £25 or 2 for £40 An essential daily nutrition product which revitalises the hair root system.

Improves hair condition and cleanses the scalp. Extracted from plants, Ervamatin provides a cure for baldness and alopecia and is recognised by the World

Health Organisation.

Ruturaj Ayurvedic Oil - (200ml) £20 Stops hair loss in 3 days, dandruff and split ends - 100% results.

Afgan Oil - (100 ml) £15 or 2 for £25 A natural brain and hair nutrient, beneficial in chronic headache, mental tension, exhaustion, insomnia and dry scalp. It prevents premature greying.

Amla-Shikakai Ayurvedic Shampoo (500 ml) £25 A powerful hair and scalp cleanser for oily hair. Helpful in removing dandruff and preventing hair loss. Neem Shampoo is for dry hair.

Our herbal hair mask is very effective for dandruff and alopecia.

We'd love to hear from you regarding any enquiries, contact Ayurvedic Nature Cure, 22 The Square , Whitefield , Manchester M45 7UL. Tel: 0161 796 2944 / 07882 830 893 Visit: www.ayurvedicnaturecure.co.uk.

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Homeopathy treats the whole person and not just the illness

Dr. Veja Gorania (DHMS)

Principles of Homeopathy A substance that causes symptoms in a healthy person can be used to treat these symptoms when they occur in an ill person.

Diluting the homeopathic medicine increases its curative powers and avoids unwanted side effects.

How are Homeopathy medicines made?

Homeopathic medicines are prepared by taking a solution of the concentrated ingredient and diluting it many times. Vigorous shaking of the preparation is vital at each stage of dilution.

Can homeopathy treat a wide range of ailments?

Homeopathy medicines are available for a range of conditions, from cuts and bruises to stomach upsets and colds. It can cure chronic disease also.

Vitiligo Vitiligo is the formation of coloured patches on the skin.

Homeopathy medicine and Dr Gorania's method of treat-

Homeopathy Clinic Vitiligo (Lukoderma) will be treated after knowing the reason behind the problems in individual cases, with the LM potency method. We assure of getting the disease rooted out fully, with guarantee of free treatment if the problem reoccurs ever in the lifetime. Modern medicine and science has no cure for that.

Cure for other ailments like Eczema, Psoriasis, Asthma, Rheumatism, Hair problems, Sex problems, Infertility, Migraine, Colitis, Gastric problems etc.,

Dr. V. D. Gorania 11 Grove Rd, Houghton Regis, Beds LU5 5PD

Tel: 01582 861321 Mob.: 07801 538 642 Visit : www.homeopathic-clinic.com Email: vgorania@doctor.com Patients will be attended to at London (Ilford, Wembley), Leicestershire, Manchester and Birmingham branches also. (Only by appointment) For Astrological consultation and future predictions contact Mrs. Santok Gorania on 01582 861321

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ment in particular, take the fundamental causes into consideration to treat the problem with assurance that if disease reoccurs then patient is treated for free. Allopathic medication does not have this precise treatment.

As a forward looking organisation, the homeopathic clinic provides the very latest research -based Homeopathic treatments with a service that is second to none.

For More Information contact: Dr. Veja Gorania(DHMS) 11 Grove Road, Houghton Regis, Beds LU5 5PD Phone: (0044)15828 61321 / 07801 538 642 Email: vgorania@doctor.com , Web: www.homeopathic-clinic.com Clinics in Leicester, Birmingham, London, Manchester (By appointment only).

GUJARAT SAMACHAR AND ASIAN VOICE

TYING THE KNOT Celebrating the ASIAN WEDDING Special Issue - 23rd Feb 2008 The A4 glossy wedding special published by Asian Voice and Gujarat Samachar will showcase the wide variety of products and services that our readers can shop from.

Our wedding special in 2007 was much appreciated by advertisers for its high quality and for the excellent response from readers. We have no doubt that your presence in the 2008 special issue will be received with a similar response.

Call Sales on 0207 749 4085 / 83

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Hair loss problem - Dr.Rohit Shah

D

r. Rohit Shah has given new hope for people suffering from hair loss from all over the world.

His treatement has became very popular with its “ no oral therapy� treatment for different type of hair loss (alopecia). He treats his patients with herbal oil, herbal powder, herbal gel and herbal paste which are topical applications made from fresh herbs.

There are different types of alopecia like androgenetic alopecia, diffuse alopecia, traction alopecia, cicatricial alopecia etc. Among all, alopecia areata is a highly unpredictable, auto-immune skin disease resulting in the loss of hair on the scalp and also elsewhere on the body. Perfect etiology of alopecia areata is still not known but medical science believes that the affected hair follicles are mistakenly attacked by a person’s own immune system (white blood cells), resulting in the arrest of the hair growth stage.

Alopecia areata usually starts with one or more small, round, smooth bald patches on the scalp and can progress to total scalp hair loss (alopecia totalis) or complete body hair loss (alopecia universalis).

Ayurveda is an ancient Indian medical science. Its origin can be traced back to the vedas- the ancient books of knowledge, or science from India. Ayurveda has described alopecia areata as indralupt.

Before

After

The advantages of herbal therapy includes no oral drugs, no chemicals and no side effects. It is 100 per cent safe when compared to any other therapy.

Dr. Rohit Shah has treated 9000 patients for hair loss problems from all over the world and the results are amazing.

More details can be seen at www.alopeciacure.com Dr. Rohit shah, Herbal tricologist E-mail: rohit@alopeciacure.com.

Jagdeep Nanchahal Professor of Hand, Plastic and Reconstructive Surgery Imperial College, Charing Cross Hospital, London

Private secretary:

Tel: 020 8810 9544 email: valerie.giles@waitrose.com www.jnanchahal.com Asian Voice - 2008 Gujarat Samachar

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